BÁO CÁO CA LÂM SÀNG: KẾT QUẢ ĐẶT SHUNT DẪN LƯU MÀNG PHỔI - BUỒNG ỐI ĐIỀU TRỊ TRÀN DỊCH MÀNG PHỔI THAI NHI

Abstract

This study describes the outcomes of successful pleuroamniotic shunt placement for the treatment of fetal pleural effusion at the Fetal Intervention Center, Hanoi Obstetrics and Gynecology Hospital. This case report was conducted on a 22-week pregnant woman who was diagnosed with left-sided fetal pleural effusion. Amniocentesis was performed for genetic evaluation, and the results of karyotyping, chromosomal microarray analysis, cytomegalovirus (CMV), and parvovirus B19, Real-time PCR revealed no abnormalities. At 25 weeks and 3 days of gestation, ultrasound examination demonstrated severe left-sided pleural effusion causing lung collapse and cardiac compression, and a pleuroamniotic shunt was subsequently placed. After the procedure, follow-up outpatient ultrasound examinations showed a thin residual fluid layer in the left pleural cavity, which completely resolved after several weeks, with good lung re-expansion and correct positioning of the pleuroamniotic shunt. The pregnancy was terminated at 34 weeks of gestation, when a cesarean delivery was performed due to signs of labor. A neonate weighing 2,350g was delivered with Apgar scores of 9 and 10. Postnatally, the pleuroamniotic shunt was removed, and chest radiography demonstrated well-expanded lungs with no blunting of the costophrenic angles. Treatment of fetal pleural effusion with pleuroamniotic shunt placement represents a feasible and minimally invasive therapeutic option. This case, among the first reported in Vietnam, highlights the potential benefits of early shunt placement in reducing risks and improving perinatal outcomes.